Prevention of Sexually Transmitted Diseases- rise in reported rates

As sex-transmitted disease rates soar in Colorado and elsewhere, states beg for help

MaineWriter- Many years ago I was working at Johns Hopkins Hospital in Baltimore, at time where the national public health urgency was focused on finding ways of diagnosing sexually transmitted syphilis earlier and faster, so as to help prevent the spread of the epidemic.  

Although progress was made at the time, the prevention and treatment of sexually transmitted diseases STDs has regressed as per this article in the Colorado Springs news:

A report by Kimberly Leonard and reported in the The Gazette and the Washington Examiner

State and local officials are begging Congress and federal agencies to spend more money to halt an alarming rise in sexually transmitted diseases, which have climbed steadily in Colorado and elsewhere over recent years.

“We are basically all expressing the same concern and expressing the need for urgent action,” said Dr. Nate Smith, president-elect for the Association of State and Territorial Health Officials. “This is something that is not going to go away on its own.”

More than 2.3 million cases of chlamydia, gonorrhea and syphilis were reported in 2017, say preliminary data from the U.S. Centers for Disease Control and Prevention.

That’s nearly a 9 percent increase from 2016 and a higher rate than those reported in other developed nations.

Even more worrisome, syphilis last year caused nearly 1,000 babies to be born with deformities or severe health problems — a 20-year high and a doubling in four years. If untreated, chlamydia and gonorrhea can make women sterile.

Colorado chlamydia rates “increased steadily from 2007 to 2016, with two dips in 2010 and 2013,” reported the state Department of Public Health and Environment.

As of 2016, the most recent year with available data, 25,569 chlamydia cases were reported in the state. That’s a rate of 461.7 cases per 100,000 people, compared with 497.3 per 100,000 people nationwide that year.

By county, Colorado chlamydia case rates are highest in Denver — 908.7 cases per 100,000. El Paso, Adams and Arapahoe counties are among seven others with chlamydia rates higher than 500 per 100,000 people.

Gonorrhea and syphilis rates also have increased in Colorado in recent years. Denver has the highest gonorrhea and second-highest syphilis rates.

“We know what we have to do to respond,” Daniel Shodell, deputy director for disease control at the CDPHE, told The Gazette in May.

“And we’re really focused on testing, treating and encouraging people to protect themselves.”

Dr. Chris Nevin-Woods, medical director for El Paso County Public Health, has said public health funding to address STDs has not kept up with the outbreak.

Over the past 15 years, the purchasing power of federal funding devoted to fighting STDs, which goes to state and local public health programs, has fallen by 40 percent. But because STDs have risen so dramatically so quickly, officials say it’s time to invest more federal money to fight it.

The National Coalition of STD Directors has asked for a $70 million annual increase in STD prevention and treatment and for the Trump administration to come up with a federal plan to coordinate the work of health agencies.

The group also asks the administration to declare a public health emergency for STDs, as it did for opioids. Such a designation would free federal funds that help officials respond faster.

The money would go to STD clinics, to protect babies from syphilis effects and to combat drug-resistant gonorrhea, which can lead to long hospital stays, disability or death. The CDC estimates STDs cost the U.S. $16 billion a year.

Smith, who is also director of the Arkansas health department, said with more money, his state would hire more health-care workers who reach out to sexual partners of infected people and bring STD testing and education to vulnerable communities. Such interactions help people get treated and talk about protection, he said.

State and local officials are meeting with top federal health officials regularly and have found discussions encouraging, said David Harvey, executive director of the National Coalition of STD Directors.

Before 2013, STDs were on the decline. Now even more common STDs, including herpes and human papillomavirus, which can lead to cervical cancer, aren’t tracked by the federal government. HIV rates are reported separately.

More people are using drugs to prevent HIV transmission, and more women are using long-term contraceptives. But condom use appears to be falling by the wayside, raising STD rates.

Gonorrhea diagnoses increased by 67 percent from 2013 to 2017, nearly doubling among men and increasing by nearly a fifth among women, the CDC reports. Syphilis diagnoses nearly doubled, mostly among men who have sex with men. Chlamydia was the most common condition reported to the CDC in 2017, accounting for 1.7 million diagnoses.

“This is the continuation of a persistent and troubling trend,” said Kyle Bernstein, chief of the Epidemiology and Statistics Branch in the CDC’s Division of STD prevention.

Some politicians are taking note. U.S. Sen. Patty Murray of Washington state, top Democrat on the Health, Education, Labor and Pensions Committee, wrote to to Surgeon General Jerome Adams in October, saying: “I write to ask that you take immediate action to raise public awareness of the problem and engage all relevant federal agencies in taking evidence-based steps to address the problem, with particular focus on prevention amongst populations most at risk of contracting STDs.”

Ahead of budget deliberations this year, 10 Democratic senators and 36 Democratic representatives asked their appropriations leaders for more money to fight STDs. They didn’t get it, but Harvey said advocates hope the money will be in President Trump’s budget request in February. The federal government now spends about $157 million a year to fight STDs.

Experts say the 2.1 million people addicted to opioids, such as heroin and prescription painkillers, contribute to the rise in STD rates, because people are trading sex for drugs.

Meanwhile, the Food and Drug Administration has rolled out a few proposals to deal with drug-resistant bacteria. The CDC has urged doctors to test women for syphilis not only when they learn they are pregnant, but also a couple of times throughout their pregnancies.

The opioid crisis, which claimed 40,000 lives last year, and other public health issues such as obesity and nicotine addiction have pushed the STD surge into the shadows, Smith said.

“If you look at the numbers, it’s really pretty bad… You can’t look at that kind of increase for any transmissible disease and not be very, very alarmed,” he said.

Colorado Politics contributed to this story.